The purpose of this study is to explorethe brain excitability in patients undergoing heart valve replacement surgery with cardiopulmonary bypass and the correlation with postoperative delirium
Delirium is the most common surgical patients postoperative complications of brain dysfunction. Delirium is a kind of consciousness attention and cognitive function changes of acute brain dysfunction, with volatility and reversibility of postoperative delirium (POD), increased hospital costs and length of hospital stay and mortality rate, and can lower the quality of life, lead to long-term postoperative cognitive dysfunction and dementia. The incidence of postoperative cognitive dysfunction in patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB) can be as high as 44-53%. However, since the specific mechanism of POD is still not clear, there is still a lack of effective prevention and treatment measures. Therefore, early detection and identification are helpful for the early treatment of POD.When brain injury occurs, the levels of excitatory neurotransmitters (glutamate and aspartate) will rise in a short period of time, and the high concentration of glutamate causes excessive intracellular calcium flow, causing cellular calcium overload, and generating excitatory cytotoxic effects. And abnormal electroencephalogram (EEG) is a kind of due to brain excitability/inhibitory amino acid imbalance caused by brain excitability increased result in abnormal discharge mode, can affect cognitive awareness and activities. Increased brain excitability is harmful to the potential, should avoid to happen. At present, the relationship between brain excitability and POD is still in exploring. Therefore, it is important to clarify the correlation between brain excitability and POD in patients undergoing cardiac valve replacement under CPB for improving the pathogenesis of POD.
Study Type
OBSERVATIONAL
Enrollment
90
General Hospital of Ningxia Medical University
Yinchuan, Ningxia, China
RECRUITINGThe incidence of delirium after cardiac surgery
Postoperative evaluation delirium occurrence use the The Confusion Assessment Method(CAM) or The Confusion Assessment Method-intensive care unit(CAM-ICU).
Time frame: The first day after surgery
The incidence of delirium after cardiac surgery
Postoperative evaluation delirium occurrence use the The Confusion Assessment Method(CAM) or The Confusion Assessment Method-intensive care unit(CAM-ICU).
Time frame: The second day after surgery
The incidence of delirium after cardiac surgery
Postoperative evaluation delirium occurrence use the The Confusion Assessment Method(CAM) or The Confusion Assessment Method-intensive care unit(CAM-ICU).
Time frame: The third day after surgery
Abnormal EEG during surgery
The EEG was collected by Masimo instrument, and the EEG was recognized by the neuroelectrophysiologist, to identify whether the EEG of the patient was epileptic discharge and burst suppression during anesthesia
Time frame: Complete EEG information from entry to exit of the operating room
Plasma excitatory amino acid levels
Venous blood 5ml was collected and centrifuged (3500r/min,10min)，sera were separated and put into -80 deep temperature refrigerator for testing plasma excitatory amino acid levels.
Time frame: Before the operation after entering the operating room (baseline)
Plasma excitatory amino acid levels
Venous blood 5ml was collected and centrifuged (3500r/min,10min)，sera were separated and put into -80 deep temperature refrigerator for testing plasma excitatory amino acid levels.
Time frame: Immediately after surgery
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Plasma excitatory amino acid levels
Venous blood 5ml was collected and centrifuged (3500r/min,10min)，sera were separated and put into -80 deep temperature refrigerator for testing plasma excitatory amino acid levels.
Time frame: 24 hours after surgery